Category: General Interest

We all know that there are never enough donor organs available for the people who need them, and even among donated hearts, seven of ten go unused – partly because of the limitations imposed by transporting the organ ‘on ice.’ So, Massachusetts-based medical device company, TransMedics decided to remove the ice from the equation entirely and … keep the heart beating during transport.

Hearts would be the highest profile option here, but the technology extends to other candidate organs as well, and in all cases such “living organ transplants” not only extend the time window between donation and reception, but they also allow surgeons a chance to assess the donor organ’s function outside the body. As the company puts it, “Hearts beat, lungs breathe, kidneys produce urine, livers produce bile.”

The British Medical Journal, in a tradition dating back some 30 years, features some unusual research in its annual Christmas issue – research that is entirely sound from a scientific viewpoint, but perhaps a bit skewed from every other viewpoint.

And finally, in a meeting of the performing and the medical arts, “A Christmas Renaissance,” touches upon Shakespeare’s ‘dramatic’ use of (among other things) uroscopy, amputation, hysteria, dementia, syphilis, midwifery, gout, poisons, homeopathy, fistulas, nursing, epidemics, death, toothache, sphygmology, and of course, constipation. O brave new world! That has such science in’t!

Written by Dorothy Grant, one time consumer reporter for CBC Television in Halifax, Turn The Other Cheek tells the story of a woman’s life with, and triumph over facial deformity. Though born with a significant disfigurement, Charlotte led a rich, exciting, and fully creative life filled with music, travel, war work, true love, and a life-changing relationship with one of the most legendary and innovative plastic surgeons of the WWII era. Despite challenges that would have derailed most, Charlotte’s undaunted spirit and joyful, courageous perspective created a life-affirming story that had to be told.

Turn The Other Cheek is available in store or online through this link.

The Johns Hopkins Bloomberg School of Public Health was established in June, 1916 and has grown into the largest public health training facility in the United States with a mandate to facilitate, “…research, education and practice to create solutions to public health problems around the world.” And in commemoration this anniversary, the school has collected one item that has made a significant impact on public health (for good or ill) for every year of that century and posted them online at “100 Objects.”

Presented in a simple grid of images, each one linking to more detailed essays, some of the objects are fairly obvious, like airbags and ambulances, but others, like luminescent watches and Horseshoe Crabs might be a bit puzzling. Still others are so ubiquitous that despite their obvious advantages, we hardly give them a second thought (think window screens, paper cups), and some may not be limited to the public health benefit that immediately springs to mind. Granted, sidewalks reduce your odds of getting hit by a car, but they also reduce obesity by encouraging walking over motorized transport.

When we think of our health, we tend to think of advances in pharmaceuticals, surgery, etc., but we’re surrounded every day by things that may have more impact on our personal, our neighbourhood’s, our planet’s health than any of those. After all, mosquitoes are estimated to kill 725,000 people a year, yet a $2.50 mosquito net can reduce the chance of infection by 90%. 100 Objects effectively makes the point that public health is not a question of one or two pivotal breakthroughs, but a vast and continually growing collection of advances and changes in practice that each contribute to keeping us alive and well.

…which is to say, we won’t be talking about how drivers are treated after accidents. In fact, this particular breakthrough has more to do with the health of the cars.

If you’ve ever watched a broadcast of a Formula 1 race, you’ll have seen the bottom of the screen showing real-time readouts of a car’s speed, gear, g-forces in a corner etc., and in the pits, the crews are receiving a continuous stream of data on hundreds of parameters per second while the car is on the track – resulting in the transmission of over 700 million numbers, per car, per race.

And what does this have to do with hospitals (UK’s Birmingham Children’s Hospital to be specific)? Well, the BCH is using McLaren’s technology and wireless sensors to monitor its young patients on a continuous basis, rather than just checking vital signs every few hours. Before long, it might be possible for outpatients to take this technology home, so their recovery can continue to be monitored remotely. You can find a detailed article on the pilot project here, and a Ted Talk by McLaren’s Peter van Manen here.

But motorsport’s recent contributions to healthcare aren’t limited to the technological. Another children’s hospital in the UK (the Great Ormond Street Hospital for Children) has been using Formula 1’s ability to refuel and change a race car’s 4 tires in less than 7 seconds (or three seconds now that refueling has been phased out) to learn how to better manage handovers from Surgery to Intensive Care.

Pediatric Anesthesia, May 2007

Pediatric Anesthesia, May 2007

During a time when, for example “…all the technology and support (ventilation, 2-4 monitoring lines, multiple inotropes and vasodilators) is transferred twice, from theater systems to portable equipment, then to the intensive care systems, within 15 min…” the congregation of so many people with diverse tasks in close quarters and under tight time constraints has definite parallels to a pit stop – and the precision choreography of a Formula 1 pit crew has been a useful model in increasing efficiency and reducing errors.

A 2007 study and an October 2015 presentation about Great Ormond Street Hospital for Children’s explorations into this surprising resource for hospital efficiency.

Sometimes genius is simply a matter of bringing together two seemingly unrelated fields and finding the connections.

The nineteenth century saw major advances in the practice of surgery. In 1750, the anatomist John Hunter described it as “a humiliating spectacle of the futility of science;” yet, over the next 150 years the feared, practical men of medicine benefited from a revolution in scientific progress and the increased availability of instructional textbooks. Anesthesia and antisepsis were introduced. Newly established medical schools improved surgeons’ understanding of the human body. For the first time, surgical techniques were refined, illustrated in color, and disseminated on the printed page.

Crucial Interventions follows this evolution, drawing from magnificent examples of rare surgical textbooks from the mid-nineteenth century. Graphic and sometimes unnerving yet beautifully rendered, these fascinating illustrations, acquired from the Wellcome Collection’s extensive archives, include step-by-step surgical techniques paired with depictions of medical instruments and depictions of operations in progress.

Arranged for the layman (from head to toe) Crucial Interventions is a captivating look at the early history of one of the world’s most mysterious and macabre professions. Sample illustrations and a more complete review of the book can be found here.

The British Medical Journal, a venerable, internationally respected publication some 175 years old, with an online presence that dates back 20 years, and an online archive stretching back to 1840, has in more recent years also gained some well deserved fame for its annual Christmas articles – compelling research on … not really vital matters. (Though the authors may disagree.)

This year’s edition offers a bit of activity and interactivity as well. “Conflict of Interest Bingo” adds a sporting element to news reports and press releases related to questionable … ‘relationships’ between scientists and industry, and “Are you pharmiscuous?“allows doctors to self-diagnose their own relationships with their friendly neighbourhood pharmaceutical reps.

What with December on the horizon and panicked gift shopping just days away, we thought we’d highlight a few medical books that fall more into the “General Interest’ category, as opposed to specific areas like Surgery or Cardiology. Since they’re not big sellers, we tend to only keep a couple on hand at any one time, but this list might inspire other ideas, and if you’re interested in a title that we’ve sold out, we can probably get it in a week or two (or as little as two days if they have it in the warehouse).

Most of the titles are also available through our Virtual Bookstore, and if you click on the cover images, you’ll be taken to a new page to order that title, and it will ship directly from the distributor to your door. (Again, if there are none in the distributor’s warehouse, they can be brought in relatively quickly, but you’ll probably want to have a week or two safety margin.)

So with no further ado, and in no particular order…

Professor Desmond Leddin, of the Dalhousie Medical School, has compiled a short history of the lives of Dalhousie volunteer doctors and nurses as they served with the 7th Canadian Stationary Hospital in WWI. (They left Halifax on their way to France 100 years ago this New Year’s Eve.)

The book, containing 104 pages with 50 photographs, includes information from the unit’s war diary, correspondences, personal anecdotes of hospital members, and even reproductions from the scrapbook of nurse Alice Johnson. For such a slim volume, this is a surprisingly time-consuming title, as you spend long minutes pouring over each image and reminiscence.

=====================================================

This funny, candid memoir of McCarthy’s intern year at a New York hospital provides a scorchingly frank look at how doctors are made, taking readers into patients’ rooms and doctors’ conferences to witness a physician’s journey from ineptitude to competence. McCarthy’s one stroke of luck paired him with a brilliant second-year adviser he called “Baio (owing to his resemblance to the Charles in Chargestar), who proved to be a remarkable teacher with a wicked sense of humor. McCarthy would learn even more from the people he cared for, including a man named Benny, who was living in the hospital for months at a time awaiting a heart transplant. But no teacher could help McCarthy when an accident put his own health at risk, and showed him all too painfully the thin line between doctor and patient.

“Thanks to Dr. Matt’s column, I know why tennis players grunt, and why five-finger shoes are for morons, and why I should have gotten a vasectomy during March Madness. And thanks to this book, I now know how he became the kind of doctor that I feel comfortable going to with stupid drunken questions.” —Drew Magary, author of The Postmortal and Someone Could Get Hurt

“Hilarious, horrifying and ultimately inspiring, The Real Doctor Will See You Shortly is a hallucinogenic trip through a doctor’s first year, filled with ill-fated pin pricks, misdiagnosis, disappearing patients, life and, inevitably, death. Beautifully written and impossible to put down, here is the unvarnished look at how we create the flawed and ultimately heroic human beings who save our lives—and sometimes don’t.” —Steve Fainaru, co-author of League of Denial

Strange Medicine casts a gimlet eye on the practice of medicine through the ages that highlights the most dubious ideas, bizarre treatments, and biggest blunders. From bad science and oafish behavior to stomach-turning procedures that hurt more than helped, Strange Medicine presents strange but true facts and an honor roll of doctors, scientists, and dreamers who inadvertently turned the clock of medicine backward:

• The ancient Egyptians applied electric eels to cure gout.
• Medieval dentists burned candles in patients’ mouths to kill invisible worms gnawing at their teeth.
• Renaissance physicians timed surgical procedures according to the position of the stars, and instructed epileptics to collect fresh blood from the newly beheaded.
• Dr. Walter Freeman, the world’s foremost practitioner of lobotomies, practiced his craft while traveling on family camping trips, cramming the back of the station wagon with kids—and surgical tools—then hammering ice picks into the eye sockets of his patients in between hikes in the woods.

Strange Medicine is an illuminating panorama of medical history as you’ve never seen it before.

=====================================================

The Man Who Touched His Own Hearttells the raucous, gory, mesmerizing story of the heart, from the first “explorers” who dug up cadavers and plumbed their hearts’ chambers, through the first heart surgeries-which had to be completed in three minutes before death arrived-to heart transplants and the latest medical efforts to prolong our hearts’ lives, almost defying nature in the process.

Thought of as the seat of our soul, then as a mysteriously animated object, the heart is still more a mystery than it is understood. Why do most animals only get one billion beats? (And how did modern humans get to over two billion-effectively letting us live out two lives?) Why are sufferers of gingivitis more likely to have heart attacks? Why do we often undergo expensive procedures when cheaper ones are just as effective? What do Da Vinci, Mary Shelley, and contemporary Egyptian archaeologists have in common? And what does it really feel like to touch your own heart, or to have someone else’s beating inside your chest?

Rob Dunn’s fascinating history of our hearts brings us deep inside the science, history, and stories of the four chambers we depend on most.

=====================================================

The riveting history of tuberculosis, the world’s most lethal disease, the two men whose lives it tragically intertwined, and the birth of medical science.

In 1875, tuberculosis was the deadliest disease in the world, accountable for a third of all deaths. A diagnosis of TB—often called consumption—was a death sentence. Then, in a triumph of medical science, a German doctor named Robert Koch deployed an unprecedented scientific rigor to discover the bacteria that caused TB. Koch soon embarked on a remedy—a remedy that would be his undoing.

When Koch announced his cure for consumption, Arthur Conan Doyle, then a small-town doctor in England and sometime writer, went to Berlin to cover the event. Touring the ward of reportedly cured patients, he was horrified. Koch’s “remedy” was either sloppy science or outright fraud.

But to a world desperate for relief, Koch’s remedy wasn’t so easily dismissed. As Europe’s consumptives descended upon Berlin, Koch urgently tried to prove his case. Conan Doyle, meanwhile, returned to England determined to abandon medicine in favor of writing. In particular, he turned to a character inspired by the very scientific methods that Koch had formulated: Sherlock Holmes.

Capturing the moment when mystery and magic began to yield to science, The Remedy chronicles the stunning story of how the germ theory of disease became a true fact, how two men of ambition were emboldened to reach for something more, and how scientific discoveries evolve into social truths.

=====================================================

From surgeon and bestselling author Atul Gawande, a book that has the potential to change medicine—and lives.

Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.

Through eye-opening research and gripping stories of his own patients and family, Gawande reveals the suffering this dynamic has produced. Nursing homes, devoted above all to safety, battle with residents over the food they are allowed to eat and the choices they are allowed to make. Doctors, uncomfortable discussing patients’ anxieties about death, fall back on false hopes and treatments that are actually shortening lives instead of improving them. And families go along with all of it.

In his bestselling books, Atul Gawande, a practicing surgeon, has fearlessly revealed the struggles of his profession. Now he examines its ultimate limitations and failures—in his own practices as well as others’—as life draws to a close. And he discovers how we can do better. He follows a hospice nurse on her rounds, a geriatrician in his clinic, and reformers turning nursing homes upside down. He finds people who show us how to have the hard conversations and how to ensure we never sacrifice what people really care about.

Riveting, honest, and humane, Being Mortal shows that the ultimate goal is not a good death but a good life—all the way to the very end.

=====================================================

In a book as eye-opening as it is riveting, practicing nurse and New York Times columnist Theresa Brown invites us to experience not just a day in the life of a nurse but all the life that happens in just one day on a hospital’s cancer ward. In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands–as both a dedicated nurse and an insightful chronicler of events–we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity.

Every day, Theresa Brown holds patients’ lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him–or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

“Out” in this case meaning that they’ve been released to the world, but not yet bound into books.

The preliminary release dates for the ECC and ACLS books respectively are November/December and March/April (though given the 2010 edition’s shipping dates of March 2011 for the ECC, and December 2011 for the ACLS Handbooks, we’re taking an appropriately medical ‘wait and see’ position about that).

In the meantime, if you have a 2010 edition now (or need to get one before the 2015s are on the shelves), you can download a thorough 36-page PDF of the changes (pictured above) here, a 7-page ‘at a glance’ version here, or a side-by-side comparison chart of Key Changes between the 2010 and 2015 Guidelines here.

And while we’re waiting for the new releases, we’ll be marking the 2010 ECC Handbooks down to $26.20, and the 2010 ACLS Provider Manuals to $36.47.

A little something from BBC’s BritLabs collection which introduces, among other things, the spiders that mate on your face and lay eggs in your follicles while you sleep, what various types of body lice tell us about our collective pre-history, and the fact that numerically speaking, we’re more bacteria than human (and about 50% of our DNA is parasitic).

As a follow up to our June 6th post, here we have another example of a patient providing real time feedback during brain surgery. (And if you poke around YouTube, you’ll find even more.)

Opera (Schubert) instead of the Beatles this time – and this time, in the words of the patient in his notes with the video, “things start to get very interesting” just after the 2:40 mark. No worries, though, it all works out fine.

So how long before we’ll have a Billboard Top Ten list for O.R. cover music?

Well, what with moving, re-moving, fall text orders, summer vacations, and special missions for the government that we’re not allowed to talk about but involve the safety of the free world, it’s been almost a month since the last post – so by way of compensation, today we offer three sites that we’ve come across during our absence…

The inability to pose the question in the first place might be a good early indicator, and one that doesn’t even require a medical degree, but the article in fact reviews the very real -albeit very uncommon- phenomenon of being, in the words of Monty Python, “…not quite dead…” and the risks associated with that state.

Like many fears we have today, the worry vastly overpowered the unlikelihood of ever falling victim to an over-eager mortician, but the thought of waking inside a coffin under six feet of dirt was enough to inspire some interesting methods of ensuring that the departed wasn’t just waiting for a really vigorous wake-up call.

And speaking of wake-up calls, you might be surprised to know that most of you are using a psychoactive drug on a daily basis, so Fusion’s “What Caffeine Does To Your Brain” could be a real eye-opener. As for the validity of the DSM-5’s listing caffeine withdrawal as a mental disorder, we leave that to the sleep-deprived debates of more qualified authorities.

Though if you are trying to beat a caffeine, or more serious, addiction, your brain’s ability to ‘rewire’ itself is your best bet – and Alta Mira’s infographic on Neuroplasticity does a nice job of reviewing current knowledge about how your brain can actually change its physical structure throughout your life. (Something that had been thought impossible until recently.)

After covering some basic facts (there are about 86 billion neurons in the human brain), and explaining factors like the brain’s pleasure/reward loop, Alta Mira not only extrapolates this information into an explanation of the mechanisms behind developing (and breaking) addictions, but offers a few examples of empirical evidence linking brain use to brain structure, as well as a simple exercise to help you clear your mind when you’ve got too much going on.

With a large contribution from Elsevier and Login Brothers, anchored by the just released 25th edition of ‘Cecil’s Medicine,’ and additional resources gathered from publishers including Jaypee, Springer, and Borm, we’ve put together quite the residency package. Drop by our new location in the Student Union Building and fill out one of the 500 ballots we’ve printed for the draw on August 4th.

We’ve moved from our home of 15 years on the Carlton Campus and relocated within the main bookstore location in the Dalhousie Student Union Building. If you drop by, our desks are no longer in a direct line of sight to the books in the current floor plan (as you can see, things are a little snug at the moment), but we’re always nearby, so don’t hesitate to ask any of the staff for help – and if they can’t answer your question, they’ll find someone who can.

Brazilian bank worker and musician, Anthony Kulkamp Dias, covers the Beatles (with an impressively appropriate song selection) while undergoing brain surgery to remove a tumor. Surgeons keep the patient awake so they can monitor sensory, motor, and speech areas during the procedure and avoid or minimize damage to healthy tissue.